Can't get stat lasix on override from accudose in telemetry unit..

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Specializes in LTC, Med/Surg, Peds, ICU, Tele.

It's the craziest thing in the unit where I'm currently serving time. Love the unit, mainly because of the crew I'm working with.

It's an advanced care unit, basically a tele unit. I just can't believe that you can't get lasix out of the accudose machine stat. Instead, you need to have the doc write out the order, make sure it gets scanned down to pharmacy and wait for them to add lasix to the profile. Craziest, most illogical thing I've seen in a long time.

You have a whole list of meds you can override in the accudose, but not lasix! How crazy is that? It happened to me once, and it happened to a colleague today. His patient was in fluid overload, needed lasix stat. Good grief, what crazy new 'safe patient' mandate will they think of next? :rolleyes:

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Specializes in Tele,CCU,ER.

OMG, the same happens to me! I may need STAT metoprolol, etc and the pyxis won't let me get it, even if I try to override. I have to get an order and then scan it and wait for the pyxis to be updated! Meanwhile my patients BP is going up and up!!

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Specializes in Cardiac.

It's beyond crazy. When you need lasix, you NEED lasix stat. Sometimes it takes forever for a scanned order to get into our pyxis...

But if there is something that I feel needs to be added to the pyxis, I just call the pharmacy and have it added. Is this possible in your facility?

For instance, KCL powder wasn't on our override list. I called and told them that if I have a pt with a really low K, then I can put a lot down the DHT immediately as opposed to the hour long K runs. We got it added to the list.

For lasix, we have only the 100mg vials available for override. I have no problems getting that out and using only 20 or 40 if that's what I need at the time.

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Specializes in LTC, Med/Surg, Peds, ICU, Tele.

The pharmacy at this particular hospital is rather uncooperative. They insist on having the order scanned. Meanwhile, my collegue was unable to be at the patient's side, but was attempting to accomplish this, the charge nurse had some other stuff going on. It's crazy.

At my home hospital, they wouldn't dream of setting up such an unsafe practise.

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I can take out all of the fentanyl, morphine, hydromorphone, and midazolam in the world but we're not allowed to override APAP, promethazine, or odansetron. Explain that one.

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I can take out all of the fentanyl, morphine, hydromorphone, and midazolam in the world but we're not allowed to override APAP, promethazine, or odansetron. Explain that one.

my thought would be those are the ones that "went missing" most often.....

the general issue, is one reason nurses develope a "stash"......

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Specializes in Mixed Level-1 ICU.

Tell your manager that not having these meds on override puts patients at unnecessary risk..then tell the medical director and the director of the pharmacy.

We had same problem...speak up and things happen...be the "good" nurse and expect the status quo. Your choice.

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Specializes in CMSRN.

Our pharmacy does require a scan of the order but can call to make sure it is up ASAP. Generally less than 2 minutes. Sometimes meds are not on the emar for up to an hour if they are busy.

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Specializes in Neuro ICU and Med Surg.
I can take out all of the fentanyl, morphine, hydromorphone, and midazolam in the world but we're not allowed to override APAP, promethazine, or odansetron. Explain that one.

Yeah we can override narcs, but not routine stuff. I don't get it either. I do however believe we can override lasix.

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Specializes in Tele, Acute.

Bust open the code cart! I've seen this done. If your pt is going bad, and fluid overload can go down fast. Maybe Pharmacy will get the message when they have to deal with the code cart meds.

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Specializes in ER/Trauma.
I can take out all of the fentanyl, morphine, hydromorphone, and midazolam in the world but we're not allowed to override APAP, promethazine, or odansetron. Explain that one.
Because there are no usual "life threatening emergencies" that require the stat/override use of those drugs (save APAP for high fever I guess).

I have a pet peeve about not being able to pull a bottle of Propofol when I need to. We tube so many people in our ER, it's really super annoying to have to keep pushing propofol/versed until a tech walks down to the pharmacy to pick up a propofol bottle (and it's not like pharmacy mixes the bottle there. All they do is slap a label onto a readi-mixed bottle). :down:

Bah!

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Specializes in Telemetry/Med Surg.

Yep...it's insane. Never understood it.

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